Definition

Lichen planus is a chronic skin condition. It causes itchy, flat, scaly patches on the wrists, legs, trunk, or genitals. It can also affect the inside of the mouth and vagina. There it resembles a white spider web. It may ulcerate. Rarely, it can also become cancerous. The scalp and fingernails can also be affected. It may become wart-like in thickness. Lichen planus may continue on and off for months or years. Scratching makes this condition worse.

Causes

Not much is known about the cause. It is possibly an immunologic reaction due to genetic factors. It may be brought on by certain medications or diseases.

Risk Factors

Lichen planus is more likely to occur in the presence of:

Hepatitis C

Systemic
lupus
erythematosus

Certain prescription medications

Graft vs. host disease

Dental materials

The condition is more common in females. It is also more common and in those 30 to 60 years old. Lichen planus is rare in children and the elderly.

Symptoms

Lichen planus may cause:

Itching, flat-topped purplish bumps or scaly patches—especially on the palm side of the wrists, the top of the foot and shins, the trunk, or the genitals

Hair loss

Abnormal appearance to the nails

Milky-white, spider web-like patches in your mouth or vagina, with or without burning or discomfort

Diagnosis

Your doctor will ask about your symptoms, medications, and medical history. A physical exam will be done. Usually can be diagnosed by the appearance of the rash. You may be referred to a dermatologist.

If the diagnosis is unclear, a skin biopsy may be done.

Treatment

Talk with your doctor about the best plan for you. Treatment options include the following:

Symptom Relief

Topical or oral antihistamines to relieve itching

Other topical anti-itching products, such as menthol or eucalyptus oil

Soothing oatmeal baths

Steroid Medications

Topical steroids may be used to help decrease inflammation. Steroids may also be injected by a needle directly into a lesion. Oral or IV steroids are only used in severe cases.

Other Treatments

Retinoids or immunomodulating medications may be useful, particularly for lesions in the mouth or vagina

Ultraviolet light combined with oral medication has also been effective in widespread or resistant cases

Prevention

There are no current guidelines to prevent lichen planus. Avoid any medications that may have triggered it in the past.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.